Multiparametric MR imaging for differentiating between benign and malignant thyroid nodules: initial experience in 23...

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Thyroid Pathology

Background:

• Thyroid nodules are common, with malignancy detection being crucial for patient management.
• Accurate differentiation between benign and malignant thyroid nodules remains a clinical challenge.
• Multiparametric MRI offers potential for non-invasive characterization of thyroid lesions.

Purpose of the Study:

• To evaluate the efficacy of multiparametric MRI, combining apparent diffusion coefficients (ADCs) and time-signal intensity curves (TICs), for discriminating malignant from benign thyroid nodules.
• To assess the diagnostic performance of lesion-by-lesion and pixel-by-pixel analyses using ADCs and TICs.

Main Methods:

• Retrospective analysis of 7 benign and 16 malignant thyroid nodules using multiparametric MRI.
• Determination of ADCs at b-values of 500 and 1000 s/mm(2).
• Classification of TICs into 5 patterns based on increment ratio, peak time, and washout ratio; stepwise analysis using ADC and TIC criteria.

Main Results:

• Overall ADCs differentiated undifferentiated carcinomas (accuracy 91%) and lymphomas (accuracy 100%).
• Malignant nodules exhibited specific patterns of rapid-uptake TIC profiles and low ADC values.
• The stepwise approach using ADC and TIC criteria achieved 91% accuracy in discriminating malignant from benign nodules.

Conclusions:

• Multiparametric MRI, integrating ADCs and TICs, demonstrates significant utility in differentiating malignant thyroid nodules from benign ones.
• This imaging technique provides valuable quantitative and qualitative data for improved diagnostic accuracy.
• Further validation in larger cohorts may enhance its clinical applicability.